Healthcare Provider Details

I. General information

NPI: 1043309313
Provider Name (Legal Business Name): SHENANDOAH VALLEY FAMILY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 FOUNDERS WAY SUITE 2
STRASBURG VA
22657-3772
US

IV. Provider business mailing address

136 LINDEN DR SUITE 104
WINCHESTER VA
22601-6900
US

V. Phone/Fax

Practice location:
  • Phone: 540-465-3235
  • Fax: 540-465-3619
Mailing address:
  • Phone: 540-678-3588
  • Fax: 540-678-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: DR. JENNIFER B DWYER
Title or Position: OWNER
Credential: MD
Phone: 540-465-3235